It has become a consensus in the medical community that smog, a serious disease of cerebrovascular malformations, requires surgical treatment. However, when it comes to surgery, there are still some patients who worry about how risky the surgical treatment of smog is. In fact, this question can be thought of the other way around. Smog is actually very risky when not treated surgically. The general consensus in the academic community is that conservative treatment of smog is not very useful. Therefore, if smog is not treated, or if it is treated “conservatively”, then it is like allowing smog to develop and worsen, which will lead to bad consequences. If the disease continues to develop, it may lead to cerebral infarction or hemorrhage at any time, and the rate of disability and death is very high. Therefore, it is very dangerous not to treat smog with surgery. On the other hand, surgical treatment of smog is very safe and not very risky. Renowned neurosurgeons, who do combined vascular bypass surgery for smog, do it under a microscope and do not do anything to the brain tissue. There is a strict preoperative evaluation, a strict intraoperative protocol, a strict postoperative monitoring and management, and a systematic and complete management of the entire perioperative period to ensure safety.